OHSU StudentSpeak » Rachel Woodhttp://www.ohsu.edu/blogs/studentspeak
Who better than the students to describe what being a student at OHSU is all about?Tue, 15 Nov 2016 17:43:47 +0000en-UShourly1http://wordpress.org/?v=4.2.10This learning curve feels more like an icy cliffhttp://www.ohsu.edu/blogs/studentspeak/2012/03/09/this-learning-curve-feels-more-like-an-icy-cliff/
http://www.ohsu.edu/blogs/studentspeak/2012/03/09/this-learning-curve-feels-more-like-an-icy-cliff/#commentsFri, 09 Mar 2012 19:06:47 +0000http://www.ohsu.edu/blogs/studentspeak/?p=2850Read More]]>“Okay Mr. X, little poke… “

Ouch!

“Nearly there…”

[Mr. X is beginning to not-so-subtly pull his hand away from me]

“Shoot. Okay…just a few more minutes….”

The above scenario lasted in fact only one more minute, and that is only because Person A (me) finally called it and relinquished the task of placing Mr. X’s IV to my (much) more experienced nursing colleague. And though Mr. X was exceedingly gracious and understanding of the “learning curve” throughout the affair, I couldn’t really begrudge his small sigh of relief as I passed the needle off to the more advanced learner/master. After all, there is only so much “I’ll-be-your-pincushion-in-the-name-of-the-future-of-medicine” that one person can take.

As you may have gathered from the above montage, I am now in the process of learning how to place IVs (short for IntraVenous lines), which are tubes that feed directly into the lower-pressure side of your circulatory system. I have been granted this amazing opportunity through the Anesthesiology Interest Group’s Student IV Placement Program, in which second-year medical students are trained by several staff Anesthesiologists to place lines which allow medical providers to quickly administer medications, fluids, draw blood samples, etc. We begin our training by practicing on mannequins before graduating to each other, and finally are deemed qualified to work with real, live, patients awaiting surgery in the PACU [this acronym actually has several possible meanings but in this case Peri (surrounding) Anesthesia Care Unit]. Now about four months in, I can say with certainty that this experience ranks among the most fun, the most frustrating, and above all the most humbling of med school to date. In short, awesome.

So, what am I actually doing? Well, every two weeks I set my alarm a few hours earlier than my normal early wake up time and join the throngs of scrubbed-out (code for getting to wear those official-looking blue medical uniforms) people making their way up or down the darkened streets of Marquam Hill into the brightly-lit building of OHSU hospital. Once there I stash my backpack (a dead-giveaway that I am in fact still a student, and even worse, a preclinical student) in the least obtrusive corner I can find and take a quick lap of the unit to see what’s going on that morning. I say hello to the staff, who I imagine recognize me as “that med student who’s here sometimes” (Or maybe, hopefully, Rachel). I load up my short white coat pockets with tourniquets, tape, IV needles, sterile gauze, and some cleaning pads (gauze soaked in alcohol). And then…I get started. After getting clearance from the supervising nurse I introduce myself to the patient. I explain my role on the “team” (with special emphasis on student to ensure complete transparency), obtain their consent for placing the IV, and then smile extra big to hide/reveal my nervousness as I pull on my gloves.

One of the most interesting/frustrating things about placing IV’s is how hit-or-miss (literally) this skill still seems to me. I have reviewed my anatomy ad nauseum. I have a checklist of sequential steps that I follow every time: Lay out all of my equipment, check to ensure fluids are running smoothly through the tubing, chat with the patient to make sure he or she is as comfortable as possible, adjust the bed/arm/stool position, etc. But at some point you just have to do it and here is where the margin of variable success is still frustratingly large. The look of the vein isn’t always a reliable predictor either. Just this week I missed a vein that was popping out like one of those plasticized vessels at Body Worlds. Immediately afterwards I successfully slid a line into a wispy little whip of a vein on the back of my patient’s hand. It defies logic! And as someone who appreciates and relies on logic, this challenges me. But, it also makes me ridiculously, indescribably happy. Maybe because this experience, though just as often maddening as exhilarating, makes me feel like I have arrived in some small way. That and my shiny blue scrubs…so what if I have to give them back immediately afterwards?

A final note of appreciation for the patients I get to work with. And not just my patients, all patients who come to teaching hospitals with the understanding and tolerance that learners will be part of their management team, and that in the name of said learning things don’t always go perfectly. Delays are going to be had and extra pokes will sometimes be inevitable. I am amazed by the grace and encouragement most of these patients reserve for us – many of them even go so far as to reassure me in a parental, pat-my-arm way after yet another fail and remind me to “keep at it, you’ll get there.” For this, I offer my sincerest thanks. And a promise that I will stick to my two-attempt policy when it comes to sharp needles and your arm.

]]>http://www.ohsu.edu/blogs/studentspeak/2012/03/09/this-learning-curve-feels-more-like-an-icy-cliff/feed/2Excuse us, our brains (and bellies) are fullhttp://www.ohsu.edu/blogs/studentspeak/2011/11/29/excuse-us-our-brains-and-bellies-are-full/
http://www.ohsu.edu/blogs/studentspeak/2011/11/29/excuse-us-our-brains-and-bellies-are-full/#commentsTue, 29 Nov 2011 21:26:58 +0000http://www.ohsu.edu/blogs/studentspeak/?p=2345Read More]]>Happy belated Thanksgiving all! Hopefully your weekends were filled with enough fat and sugar-filled calories to cast a soporific spell over any stress or fatigue that may have plagued you last week. Around the halls of RJH stress was plentiful as both classes prepared for exams, working hard to internalize thick, detailed syllabi. The result went something like this:

Like, really full. First-years have been cramming their brains full of cellular biology pathways and histology photos, while the second-years have been mentally cataloguing all the different flavors of diarrhea. This growing heap of information compressed intracranial space to the point where access to normal words, thoughts, and the fundamental ability to interact socially became somewhat limited.

Additionally, with Thanksgiving looming on the horizon there was a (delicious) carrot dangling on just the other side of the note-card mountain. Did you know that the mere thought of food can trigger the salivary glands in our mouths and the acid/digestive-enzyme-making glands in our gut to start oozing? Which means that in addition to feeling fried, many of us were literally drooling whilst becoming increasingly dependent on TUMS.

With that image in mind, I’m devoting the rest of this post to the top med-studentmoments from the pre-Thanksgiving slog. All of the following stories are true and retold with the permission of those involved. Please, don’t judge us too harshly.

1) Two med students are sitting in pathology lab three days before Thanksgiving. They are looking at slides under the microscope and energetically discussing the subtleties that distinguish squamous cell carcinoma (bad cancer) and adenocarcinoma (possibly even worse cancer) of the stomach. The professor overhears this conversation and remarks, “Wow, everyone else is discussing what they are going to stuff their turkeys with. You two must be the nerds of the class.” Med students leave feeling genuinely complimented.

2) One female med student to another during a small group discussion: “That shirt is so pretty Melissa[1], it makes you look so ureteral.[2]

3) One med student walks into a patient’s room reviewing the chartand opens with “So I understand you’ve been having headaches…” to which the patient kindly corrects said student that no, she has been having stomach pain. It was in fact the previous patient (with whom med student had just talked with for thirty minutes)who suffered from headaches. Patient 1, med student 0.

4) Two med students are quizzing each other for an upcoming test. Student A poses a question regarding a topic that Student B has no recollection of learning about. Notes are consulted, and after much page-flipping the confused student finds in her own handwriting the exact information she was blanking on, highlighted and underlined – twice. More coffee is poured.

The full-brain phenomenon is a real affliction and one to be taken seriously. It is generally ill-advised to perform intricate procedures or operate heavy machinery while suffering from this illness. Fortunately, the cure rate is close to 100% when the following therapy is promptly administered:

0-4 days of:

8+ hours of sleep per night.

Single servings of pumpkin pie BID (twice daily).

Time spent catching up with friends over (more) pie.

Trail runs followed by hot showers followed by pie.

A plethora of fluffy movies/TV shows, preferably watched in bed while consuming pie.

[2] The word student #1 was going for here was in fact ethereal (translation: heavenly), but due to an understandable glitch in her internal word-checker she wound up likening her friend to the appearance of the urinary tract.

How do you define “healthy?” Good cholesterol and low blood pressure levels? No family history of cancer? Balanced diet, regular exercise, sufficient sleep? Sure. But what about less obvious – and perhaps less easily quantified – traits like easy laughter, positivity, or an intact sense of humor? I don’t have a research-based answer here, but I’m beginning to suspect that truly healthy people possess these things as well, perhaps setting up some kind of positive feedback loop that makes them even healthier. Case in point: during preceptorship this past year, I met arguably my healthiest patient to date. His age? He’s pushing 100.

Act I: Clinic, early afternoon. Pan in on a med student, pre-patient encounter, sitting at a computer screen. I am scrolling through the patient’s chart while mentally compiling a list of questions I need to remember to ask.

The 90-plus year old patient is here today for routine physical exam and flu shot. His past medical history includes an appendectomy in the 1930’s and arthroscopic knee surgery in the 1990’s. No other hospitalizations. Non-smoker. Family medical history short, list of medications and allergies even shorter. “Great,” I thought, “this should be pretty straight-forward.”

Act II: Patient’s room, cue entry:

(Knock)

I open the door to find a smartly-dressed elderly man.

“Hi, I’m Rachel.” (Wash hands, shake hands). “I’m a second-year medical student working with Dr. X today. Would it be okay if I chatted with you for a bit before the doctor joins us?”

Patient smiles, scooches a little closer.

“Sure! Who are you?”

After reintroducing myself – in a slower, clearer voice – I settled onto the backless, rolling chair and began the interview.

“So Mr. Y, how are you today?”

Act III: 30 minutes later . . .

I am both embarrassed and a little pleased to admit that in those thirty minutes I did not get to reviewing his medications or discussing his family history. I didn’t even begin the physical exam. So…what the heck was I doing? Well, listening. And quite raptly I might add. This man was a true storyteller; his ability to use his entire body – voice, hands, face, even feet – to tell me about his life, his kids, his kids’ lives, etc., was completely enchanting. When I did manage to slip in pertinent medical questions – “Have you been having any joint pain, Mr. Y?” – he responded with something like:

“No! Oh wait, I suppose that when I go dancing – which is usually twice a week, mind you – my shoulder does tend to feel a little sore by the end of the evening but that’s only because most ladies just can’t keep up with me. You see I do a four-step foxtrot, not a three-step like they teach nowadays, and I end up having to lead with a slightly stronger arm if you know what I mean . . .”

You can see why I got slowed down a bit. And, perhaps, why it didn’t really bother me all that much.

I did finally get through all my questions, as well as my exam. It may have taken me forty-five minutes beyond the allotted fifteen, but I learned a great deal along the way. Specifically, this guy was healthy. And I don’t just mean his commendable vegetable intake and daily Vitamin D supplementation. His eyes were twinkly. He smiled a lot, particularly when talking about his children. During our conversation he was engaged and alert, leaning towards me to swat my leg with a bit of paper for emphasis. And he laughed, the belly kind. During his heart exam I did notice that his heartbeat was a bit wonky (medical-ese for irregular), but my preceptor later assured me that this slight abnormality was in fact perfectly normal in our ninety-plus year old patient population – particularly those who go out dancing twice a week.

]]>http://www.ohsu.edu/blogs/studentspeak/2011/11/02/cheers/feed/3Differentiation by Dahlhttp://www.ohsu.edu/blogs/studentspeak/2011/09/27/differentiation-by-dahl/
http://www.ohsu.edu/blogs/studentspeak/2011/09/27/differentiation-by-dahl/#commentsTue, 27 Sep 2011 17:35:26 +0000http://www.ohsu.edu/blogs/studentspeak/?p=1656Read More]]>As a kid, and occasionally as an adult, Roald Dahl’s books have been a staple of my literary diet. Matilda, The Witches, James and the Giant Peach, Charlie and the Chocolate Factory…the list is long and fantastic. As I was considering my topic for this month’s post, several of Dahl’s illustrations popped into my head, and I subsequently had way too much fun pulling these books out and flipping through my favorite sections.

The first reason I bring Dahl into this is that with second year now well under way, I am a little embarrassed to admit that my room is starting to resemble Matilda’s. The first day hit us like a tornado, blowing our sweet summer free time out the window and replacing it with a lengthy to-learn/to-do list full of cardiovascular disease, EKGs, complex kidney functions, and new preceptor assignments. It also brought a new theme, one that seems to be emerging more prominently this year both within the curriculum as well amongst my classmates and I.

The theme is differentiation, which is defined by the Oxford English dictionary in the following way(s):

1. verb trans. Obtain the derivative or differential of.

2. verb trans. Constitute a difference in, of, or between: serve to make different from [sic].

3. verb trans. Make different in the process of growth or development.

4. verb intrans. Become differentiated or specialized.

Several weeks ago during PCM (Principles of Clinical Medicine, the class where we learn clinical maneuvers and other wisdoms) our class received a lecture entitled “The Undifferentiated Patient.” During this hour we were taught the nuts and bolts of formulating a differential diagnosis for patients complaining of anything that could be caused by (almost) anything, such as back pain, headaches, fatigue, etc. We were given the following, four-step algorithm to help us along.

1. Consider the organ systems involved.

2. Consider the processes involved. For this we were given the handy acronym VIIINDICATE (Vascular, Infection, Inflammation, Intoxication, Neoplasm (abnormal growth), Deficiency, Iatrogenic (doctor-caused), Congenital (born with it), Autoimmune, Trauma (surgery counts), Endocrine (hormones). This acronym qualifies as Dahl-like because the extra “I’s” make it sound like the Grand High Witch’s accent from The Witches (“Qviet!”). This will also help me with retention because if she was lecturing you bet I’d be paying attention – her eyes have been known to shoot sparks and fry the occasional audience member.

3. Consider possible diagnoses for each process subcategory.

4. Rank the potential diagnoses in order of likelihood and/or severity.

This session was invaluable for me, as I have been struggling to find a way to more easily apply the tangle of information in my brain to the understanding of the patients I see with my preceptor each week. Although “headache” might sound easy enough, you’d be amazed at how difficult it feels to compile a list of all the possible causes, let alone what to do about them. I feel like VIIINDICATE might just provide the silk threads (framework) I’ve needed to lasso the seagulls (info) to keep this damn peach (brain) aloft. Or something…use your imagination won’t you?

Another kind of differentiation I’ve noticed is amongst us med students. For the most part, we all start undifferentiated on day one save the lucky few who picked out their field in preschool. The rest of us are in the process of sampling, trying on, and honing in on one or five top choices. And though we have not yet even reached the true “audition” stage of our clinical years, it seems like more of us every day are leaning more decisively in one direction, whether that means heading up an interest group, skipping the occasional lecture to attend a specialty conference, or sacrificing sleep in order to scrub in on a particularly compelling procedure. One could ask if this is the appropriate use of preclinical time, but I’m not sure there is a right answer to that question. You could also ask if we should even worry about knowing already, or if we should just relax and let the process occur a little more passively? That answer might seem more obvious, but it certainly isn’t simple.

Personally, I still feel very undifferentiated. My answer to The question (“what kind of doctor are you going to be?”) goes something like “well, Anesthesiology is fascinating and I really enjoyed my time shadowing before med school but I also think surgery is pretty darn cool and wonderfully hands-on and then there was that pediatric radiologist during GIE last year with those “baby gram” images (who knew that was even a thing?!) which I just loved and then…yeah. You get the idea.

A squirrel in the nut room, differentiating the good nuts from the bad.

]]>http://www.ohsu.edu/blogs/studentspeak/2011/09/27/differentiation-by-dahl/feed/0Insert your experience here.http://www.ohsu.edu/blogs/studentspeak/2011/09/06/insert-your-experience-here/
http://www.ohsu.edu/blogs/studentspeak/2011/09/06/insert-your-experience-here/#commentsTue, 06 Sep 2011 19:33:10 +0000http://www.ohsu.edu/blogs/studentspeak/?p=1451Read More]]>For me, as for centuries of doctors before me, my journey through these crossroads began when I first took a blade in my hand and cut a line across a dead woman’s skin.

~ Dr. Christine Montross, Body of Work

Gross Anatomy. It’s probably the most famous (and by some, the most feared) class of medical school. It’s also the first class of medical school, which adds to its mystery and prestige. As a newly minted MS2 I had the chance last week to return for the first few days of this year’s Gross Anatomy course. Along with several of my fellow MS2s we were there to help the new students decide when and where to cut, how to best differentiate between the different tissue types and structures (Is it a nerve or an artery? Muscle or fascia? These questions are harder than you might think the first time around), and hopefully even offer a little emotional support as many of the MS1s faced their first cadaveric dissection.

Standing at the back of the room it was exciting to watch the new students as they filed in, each donning brightly colored, mismatched scrubs that were currently the cleanest they were ever going to be. Teams of four and five organized themselves around the twenty-nine white-sheeted tables. Emotion was palpable in the room, a mixture of excitement, fear, sadness, awe, eagerness, and others too plentiful to name. I watched as the shrouds were removed and each group “met” their cadaver for the first time. I wondered privately which groups would name their cadaver and which would not. I noticed those students who immediately reached out to touch their cadaver’s skin and those who held back. I heard the collective exhale in the room that was followed by broad smiles, nervous laughter, and even a few tears.

Looking back, it has been exactly a year since I stood with my classmates around our own cadaver. I have clear memories of meeting her, touching her, naming her (Lily), and of working arduously over the course of many weeks to uncover and understand the many secrets her body held. The experience of dissecting is impossible to summarize so I won’t even try, but I will say that it it remains one of the most difficult and enriching experiences of my life to date. A cliché maybe, but a cliché for good reason.

In addition to helping out in the MS1 lab I also had the chance to return to Gross Anatomy as a dissector, working with three of my classmates to prepare a cadaver for the Discover OHSU! Program. On the first day of this dissection, I noticed that my feelings were distinctly different from last year – and I suspect from those unfolding in the first-year laboratory next door. The excitement remained, but it was no longer plagued by a constant anxiety of “what if I accidentally cut X?!” I felt the same deep sense of privilege and gratitude to this person, our donor, for allowing us to learn so intimately from him, but I also now felt a kind of shared pride at being part of the teaching process as well as a benefactor of it. I also felt something else that caught me by surprise – confidence – that was most certainly absent last year. Stepping up to our table I made my initial incision quickly and (relatively) decisively, running from the depression between his collarbones to the pointy part below his breastbone, and then extending the cut to both sides of his torso using the jutting of his ribs as a marker. Being able to picture the planes of tissue and structures that lay beneath my blade gave me the confidence to cut more freely, and I think to relax more fully into the experience.

So. Let me be one of many to extend a warm, gloved-handed welcome to my newest batch of colleagues. I am excited about (and a little jealous of) the course/journey you are embarking on. At the risk of sounding parental, I will say that for me Gross Anatomy was exciting, exhausting, and life changing. So pay attention, and have fun. And then come tell me your stories, because as you can probably tell I love talking about this stuff.

I received this reminder from one of my new Costa Rican friends yesterday about the experience of learning a language and the patience it requires. He is from Samara, my current residence, and has been studying English for several years. He described his ongoing frustration with the confusing vocabulary (their, there, they’re), the often irregular past tense (sit-sat, hit-hit, fit-fitted), and the ever-present idioms that make him want to cry. What struck me was that, despite what he was saying, he didn’t really seem frustrated at all – just accepting of the fact that he had a lot of stumbling ahead of him. For someone who had spent the last few days feeling a bit exhausted by the $%#! process, the timing of the reminder was perfect.

Let me shift gears a bit and tell a story about another necessary component of learning a new language, be it Spanish, English, or medicine. I was about six weeks into medical school and had the mountains of flashcards and smelly clothes to prove it. Despite the overwhelming amounts of information, I was thrilled with my exciting new life and felt I had finally discovered a routine that worked. I would get up, eat, go to class, eat, study, (exercise?), eat, study more, (eat?), sleep. Rinse and repeat. Having spent the first month and a half building up my attention-span muscles, I was astonished at my newfound capacity to focus and go without much sleep.

Around a week later, things started to shift. While I was keeping up with my demanding schedule, some new and distinctly unpleasant feelings were starting to creep in. The first was paranoia. What if none of my classmates liked me? What if I froze during an exam and remembered nothing? What if (insert your own irrational fear here)? I started to feel a little jangly, starting awake pre-alarm and reacting a little more quickly (and negatively) to harmless quips thrown out by my friends. And I was no longer sleeping well, but oddly still didn’t feel tired. I couldn’t understand why what had been working so beautifully suddenly wasn’t.

Sometime between five and six a.m. the next day I was in the middle of my normal morning routine: making coffee, packing my lunch, glancing at notes scattered on the counter, trying to cook a few eggs without starting a fire on the stove, and probably a few other things. As I was pouring the coffee I realized with shock that I was crying. And not just in the teary eyes kind of way – crying in that coursing-tears, wet-cheeks kind of way. The craziest part was that I didn’t even feel sad. Actually I didn’t feel much of anything.

It occurred to me on the way to school that maybe the powerful adrenaline wave I had been riding was now crashing down on my head, and that unless I wanted to repeat the high/crash cycle for the next four years I’d better work out some ground rules for a more sustainable life. I started simply, setting a limit to the number of hours I would study per day, giving myself a bedtime that was eight hours pre-wakeup time, and trying (hard) to accept the fact that the arc of learning was more jagged than smooth. Perhaps most difficult for my type-A personality, I tried to accept that I was never – ever – going to be able to check off every single thing on my to-do list.

A month later things were better. I was waking with the alarm and no longer crying over my coffee – at least not for no apparent reason. My friends let me know that I had become noticeably more pleasant to be around. And – a real surprise – I started doing better on my exams. (Reality disclaimer: there will be plenty of times in medical school/life where your best-laid plans will fly out the window and you will have to put your head down and just go. But this need not and should not be your daily routine.)

So.

Rather than say any more, I want to close with a picture. Here’s a little guy (un perezoso: South American sloth) I encountered in Manuel Antonio National Park. His assigned task in life is to obtain and consume what he needs to survive. He moves slowly and deliberately, with a lot of nap breaks, and when he finds food he takes the time to thoroughly chew and enjoy each bite. Our assigned tasks may be different, but in terms of how to approach them, I think he’s onto something.

Like many of my rising MS2 classmates, I have flown the Portland coop for the summer and am using the time to breathe a little non-hill air. I have landed in the beautiful country of Costa Rica where I will be spending a total of six weeks plus two days studying Spanish, traveling, and meeting as many people as possible. It has only been a few days, but the whirlwind of arriving in a brand new culture has me thinking back to the equally chaotic first few days of medical school, and the parallels that I’m noticing between the two experiences.

To begin, everything here is new and unfamiliar, which is equal parts exciting and terrifying. The air feels a little funny (wet, wet, wet), the road signs make no sense (and people seem to largely ignore them anyway, making crossing the street quite an adventure), and the words coming out of people’s mouths fly around my ears with little to no penetration or comprehension. The result is that I feel 100% out of my element, but also completely intrigued. Weird, I just got the oddest flash of déjà vu…

Of course, it’s not exactly like medical school. First of all, there are monkeys here, four kinds to be exact. Second, there are lots of incredibly friendly, interesting people who may not speak my language but are infinitely patient while they wait for me to find the right words. These same people also happen to share my love of parks, traveling to interesting places on the weekends, and a love/addiction to really good, locally made coffee. Hang on; maybe this place is exactly like medical school (plus the monkeys).
Regardless, I’m thrilled to be here. You might ask why I have chosen to spend my highly coveted “last summer” taking an intensive four-hour-a-day language course? Well, I already mentioned the monkeys. More importantly though, I think that studying Spanish might just be one of the most valuable things I can do aside from my coursework to make myself a better provider in the future. It is no secret that the percentage of Spanish-speaking patients in Oregon and the rest of United States is sizable, and growing quickly. And although we have excellent interpretive services here at OHSU, I can’t help but notice that occasionally during these visits things still get lost in translation (forgive me). It also seems that those providers who have grasped even the most basic fundamentals are infinitely more at ease with their Spanish-speaking patients, and vice versa.

So, here I go. As with medical school, my goal at this point is not perfection or necessarily even competence. Those both seem a little lofty and maybe even a bit naïve. Rather, I am going to take direction from a wise woman that I know and strive instead for a level of “conscious incompetence,” or gaining a clear understanding of what I don’t know and being okay with that. I plan on working hard, but this mindset will not only push me to keep learning but will give me a little freedom to relax about all the mistakes I (will) make along the way. Why just yesterday, I took a bite of raw plantain before realizing (from the taste in my mouth as well as the look of horror on the fruit vendor’s face), that plantains, or platanos, are a must-cook fruit. But as nobody was injured in the making of this mistake, it was a pretty easy one to laugh about and let go. I feel like there is a lesson here.

]]>http://www.ohsu.edu/blogs/studentspeak/2011/06/29/monkeys-and-medical-school/feed/2Guess I’ll Go Eat Worms…http://www.ohsu.edu/blogs/studentspeak/2011/05/20/guess-ill-go-eat-worms/
http://www.ohsu.edu/blogs/studentspeak/2011/05/20/guess-ill-go-eat-worms/#commentsFri, 20 May 2011 22:09:18 +0000http://www.ohsu.edu/blogs/studentspeak/?p=700Read More]]>Do you remember that song that kids sang on the playground, “Nobody likes me, everybody hates me, guess I’ll go eat worms…?” We used to sing this song because a) singing about worms was the height of cool in third grade and b) the idea of a worm sliding down (or up) your throat was about the grossest thing we could think of – which, after all, was the point.

Last week we received a lecture entitled “Introduction to Parasitology.” Over the course of the hour the professor illustrated in glorious full-color detail the perils and ramifications associated with the many parasites that afflict humans, from the really really tiny ones (some of which are currently clinging to your eyebrows and eyelashes – don’t bother trying to wipe them off, they’ve got quite the grip) to the alarmingly large, wormy ones that will eventually and upsettingly exit your person through whatever orifice they deem most desirable. Ew, right?

Beyond being devious, parasites are also alarmingly prevalent. Our professor hammered this point home in the following exchange:

Professor: “How many of you ever swim in fresh water?”

(About two-thirds of the class raises their hands)

Professor: A parasitologist would never swim in fresh water….

(pause for effect)

Professor: “How many of you eat fresh vegetables”

(catching on now, only about half the class take the bait)

Professor: “A parasitologist would never eat fresh vegetables.”

It went on like that, to include touching or consorting with dogs/cats/small children, visiting the beach (which is of course the domain of said dogs/cats/small children), drinking water, urinating outside, eating fish, going to tropical countries, eating meat, etc., etc., etc.

(By the way, when a brave student asked the professor what parasitologists do in fact eat, the response was “I am very very careful. Mostly red vines and lifesavers.”)

Since the lecture I have experienced a heightened sense of paranoia about, well, everything. It is far too easy to imagine giardia (an intestinal bug that your vet may have mentioned) lurking unseen on my baby carrots, or an opportunistic hookworm lying in wait for my bare feet. This worm is particularly clever; after wriggling in between my toes it will get into my blood vessels and make the journey up into my lungs (by way of my heart) to my windpipe where it will be just irritating enough to cause me to cough and swallow. This maneuver will be enough to propel the worm into my other pipe (esophagus), down to my stomach, and finally to the land of plenty, aka my intestines. All without my knowledge. Again, ew.

I am sorry to say that I am getting used to this kind of paranoia. I am not sure if other medical students suffer from this, but it seems that one result of knowing a lot about a little is the irrational belief that all those nasty things you are reading about are actually happening in your body right now. Do you have a cut that’s taking too long to heal? Immunodeficiency! Does your heart seem to be beating too fast at the moment? Atrial fibrillation! And oh my god was that a flash of chest pain? Never mind the excessive coffee, stress, and lack of sleep, this is obviously a heart attack, which will lead to clot formation, which will cause bits of the clot to break off, travel to my brain, and give me a stroke!Gah!!

I am exaggerating of course, though only a bit. I recognize the absurdity of these fears. And I am getting better at dismissing them. Nevertheless, medical school continues to make me ever more careful of my daily habits. For example, I now unashamedly wash all fruits and vegetables at least twice, if not more. Some might call that obsessive, but I figure that if I have to play host to worms I at least want them to be clean.